Joint Commission Announces 2006 National Patient Safety Goals For Home Care Program

Published Jun 1, 2005

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joint commission announces 2006 national patient safety goals for home care program

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(oakbrook terrace, ill. - may 31, 2005) the joint commission on accreditation of healthcare organizations today announced its 2006 national patient safety goals and related requirements that will apply specifically to accredited home care organizations.

major additions to this fourth annual issuance of national patient safety goals, which were approved by the joint commission's board of commissioners, include a new requirement that "hand-offs" of patients between caregivers be standardized, with particular attention to assuring the opportunity for asking and responding to questions. this requirement is part of the goal: "improve the effectiveness of communication among caregivers." in addition, a new goal encourages the active involvement of patients and their families in the patient's case as a patient safety strategy, and includes a specific requirement that the home care organization define and communicate the means for patients and their families to report concerns about safety and encourage them to do so.

"the 2006 national patient safety goals extend the joint commission's commitment to focusing attention on the greatest opportunities for improving patient safety," says dennis s. o'leary, m.d., president, joint commission. "we are confident that accredited organizations will integrate these requirements into their efforts to redesign internal systems to avoid unnecessary patient disabilities and loss of life."

the development and annual updating of the national patient safety goals and requirements continues to be overseen by an expert panel that includes widely-recognized patient safety experts, as well as nurses, physicians, pharmacists, risk managers and other professionals who have hands-on experience in addressing patient safety issues in a wide variety of health care settings. each year, the sentinel event advisory group works with the joint commission to undertake a systematic review of the literature and available databases to identify candidate new goals and requirements. following a solicitation of input from practitioners, provider organizations, purchasers, consumer groups, and other parties of interest, the advisory group determines the highest priority goals and requirements and makes its recommendations to the joint commission.

in order to maintain the focus of accredited organizations on the most critical patient safety issues, the sentinel event advisory group also recommends the retirement of selected goals and requirements each year. the following requirements will be retired in 2006.

elimination of the requirement to remove concentrated electrolytes (including but not limited to potassium chloride, potassium phosphate, sodium chloride greater than 0.9 percent) from patient care units. this requirement will continue to exist in relevant accreditation manuals.
retirement of a requirement to ensure free-flow protection on all general-use and patient-controlled analgesia intravenous infusion pumps used in an organization compliance with this requirement has been greater than 99 percent, and equipment manufacturing and availability issues for all health care settings have been satisfactorily resolved.

the net effect of these changes is that the total number of goal-related requirements for the home care program will remain unchanged.

the board of commissioners also affirmed the six existing "do not use" abbreviations that constitute a single requirement under the goal: "improve the effectiveness of communications among caregivers," but acted to delete a related stipulation that each organization also identify an additional three organization-specific "do not use" abbreviations that have been integral to this requirement as well. failure to substantially eliminate the utilization of "do not use" abbreviations in medication orders remains one of the most frequent non-compliance findings during joint commission surveys.

the 2006 home care national patient safety goals are:

improve the accuracy of patient identification.

use at least two patient identifiers whenever administering medications or blood products; taking blood samples and other specimens for clinical testing, or providing any other treatments or procedures.
prior to the start of any invasive procedure, conduct a final verification process, such as a "time out," to confirm the correct patient, procedure, and site using active - not passive - communication techniques.

improve the effectiveness of communication among caregivers.

for verbal or telephone orders or for telephonic reporting of critical test results, verify the complete order or test result by having the person receiving the order or test result "read-back" the complete order or test result.
standardize a list of abbreviations, acronyms and symbols that are not to be used throughout the organization.
measure, assess and, if appropriate, take action to improve the timeliness of reporting, and the timeliness of receipt by the responsible licensed caregiver, of critical test results and values.
implement a standardized approach to "hand off" communications, including an opportunity to ask and respond to questions.

improve the safety of using medications.

standardize and limit the number of drug concentrations used by the organization.
identify and, at a minimum, annually review a list of look-alike/sound-alike drugs used by the organization and take action to prevent errors involving the interchange of these drugs.

reduce the risk of health care-associated infections.

comply with current u.s. centers for disease control and prevention (cdc) hand hygiene guidelines.
manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with health-care associated infection.

accurately and completely reconcile medications across the continuum of care.

implement a process for obtaining and documenting a complete list of the patient's current medications upon the patient's entry to the organization and with the involvement of the patient.
a complete list of the patient's medications is communicated to the next provider of service when it refers or transfers a patient to another setting, service, practitioner or level of care within or outside the organization.

reduce the risk of patient harm resulting from falls.

implement a fall reduction program and evaluate the effectiveness of the program.

encourage the active involvement of patients and their families in the patient's care as a patient safety strategy.

define and communicate the means for patients to report concerns about safety and encourage them to do so.

the full text of the 2006 goals and requirements is posted on the joint commission website. compliance with the requirements or alternatives judged to be acceptable is a condition of continuing accreditation for joint commission-accredited home care organizations.

to view this news release online visit: http://www.jcaho.org/news+room/news+release+archives/06_npsg_ome.htm

to view the 2006 home care national patient safety goals visit: http://www.jcaho.org/accredited+organizations/patient+safety/npsg.htm